Healthcare Provider Details

I. General information

NPI: 1245691468
Provider Name (Legal Business Name): A VISITING ANGELS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 PEACHTREE ST NE STE 3650
ATLANTA GA
30309-3934
US

IV. Provider business mailing address

1075 PEACHTREE ST NE STE 3650
ATLANTA GA
30309-3934
US

V. Phone/Fax

Practice location:
  • Phone: 678-941-8122
  • Fax:
Mailing address:
  • Phone: 678-941-8122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NICOLAS GBEDEMAKOU
Title or Position: CEO/PRESIDENT
Credential:
Phone: 678-941-8122